Tuesday, 8 December 2009

Howard Dean's Democracy for America is SO Wrong

I've been a member of the Howard Dean founded group Democracy for America for several years, and I've been consistently impressed with the force, vision and vigour that they add to the political discussion in America. I like their approach of prominently backing strong progressives around the country with a chance to take the fight to Republicans in tough districts, and I'm glad they sometimes challenge the Party establishment to stay honest by raising strategic primary challenges against Democrats who disappoint them. (See Specter, Arlen for an example of how a primary challenge can sometimes go to far - Pat Toomey - but on other occassions just bring the person more comfortably in line with the party mainstream - Joe Sestak.) This is, after all, more or less how Democracy is supposed to work.

But they are spectactularly wrong about health care reform.

I've supported DFA for years - and I've met Governor Dean several times and I think he's an outstanding leader and was exactly the right DNC Chair for the moment. No one is more fervently pro-healthcare reform than I am.

As background, DFA has been lobbying extremely hard for the public option to be included in Health Insurance reform. And well done, too.

But their fundamental position seems to me more based on macho posturing of the "we've given up enough, we want candy now" thinking rather than an honest assessment of what's good and bad in the current bill,. They are currently urging their supporters to call their Senators and demand that they not compromise any further on the public option.

This is a TERRIBLE, TERRIBLE idea.

Firstly, they seem to take for granted that the bill will pass one way or another. That's just flat out not true. We're still several votes away from the majority we need to get past the filibuster.

Furthermore, an apparently pretty constructive conversation is currently happening in the Senate that isn't just focussing on "Public Option, in or out" but is actually looking at what the public option was designed to achieve and asking whether there are any other approches that could do the same thing. Some of the ideas that are being batted around strike me as not just pointless compromises, but actually substantive policy approaches in their own right. Dare I say, some of them could even be BETTER than the public option.

Consider, for example, the idea of not-for profit insurance plans administered under tight controls from the Office of Personnel and Management. This is one idea that has been floated, and it would closely replicate the way that health care is currently delivered for Federal Government employees. Although not strictly "public" in that it would not be run by the government directly, it would have all the same cost controlling power of the government run public option. Plus, and this is the bit that interests me, it's lower risk in many ways because it replicates an existing program that we know already works.

Or, what about allowing people to buy in to Medicare? What about imposing much tighter cost controls on the private sector? What about expanding the amount of subsidies available to poorer patients? All of these things are being considered - each of them might be at least as effective as the public option.

Or, they may not. To be sure, the public option - even in its current weakened form - may be the best option we currently have for controlling costs. But the one thing that we know for certain would NOT work is the status quo. And senators who reject a compromise out of some misguided notion of "Public Option or Else" will most likely condemn Americans to decades more of a flat out failed health system, and the Democratic Party to years in the wilderness. Deservedly so, by the way. If we screw this up we don't deserve to lead.

So I'm extremely unimpressed with DFA's current strategy.

They've e-mailed me today to ask me to call my Senator, with the following call to action:

Call your Senators today and tell them where you stand:

America stands with Healthcare Heroes who fight for a public option, not Insurance Industry Senators who care more about the insurance interests who fund their campaigns than providing every American real healthcare reform.

We're done negotiating. Enough is enough. The public option in the current Senate bill is our final compromise.

I sent them this note in their contact form.

You are wrong about this. The public option, while a good idea, is not even close to the most important part of this bill. In fact, in its weakened form, it may actually be a less powerful force for health cover expansion and cost controls than many other options that are now being talked about as "alternatives" to the public option - notably Medicare Expansion, increased subsidies and stronger market regulation. You are doing our joint cause great harm here, and a "victory" for your approach could actually make life worse for many Americans, while failure that results in non-passage of the bill could literally lead to the death of thousands and set our cause and our Party back for a generation.